Dataset of the livability performance of the city of Birmingham, UK, as measured by its citizen wellbeing, resource security, resource efficiency and carbon emissions.

This data article presents the UK City LIFE1 data set for the city of Birmingham, UK. UK City LIFE1 is a new, comprehensive and holistic method for measuring the livable sustainability performance of UK cities. The Birmingham data set comprises 346 indicators structured simultaneously (1) within a four-tier, outcome-based framework in order to aid in their interpretation (e.g., promote healthy living and healthy long lives, minimize energy use, uncouple economic vitality from CO2 emissions) and (2) thematically in order to complement government and disciplinary siloes (e.g., health, energy, economy, climate change). Birmingham data for the indicators are presented within an Excel spreadsheet with their type, units, geographic area, year, source, link to secondary data files, data collection method, data availability and any relevant calculations and notes. This paper provides a detailed description of UK city LIFE1 in order to enable comparable data sets to be produced for other UK cities. The Birmingham data set is made publically available at http://epapers.bham.ac.uk/3040/ to facilitate this and to enable further analyses. The UK City LIFE1 Birmingham data set has been used to understand what is known and what is not known about the livable sustainability performance of the city and to inform how Birmingham City Council can take action now to improve its understanding and its performance into the future (see "Improving city-scale measures of livable sustainability: A study of urban measurement and assessment through application to the city of Birmingham, UK" Leach et al. [2]).

Meta-analysis showing the beneficial effect of α-blockers on ureteric stent discomfort.

UNLABELLED: What's known on the subject? and What does the study add? Ureteric stents cause significant discomfort and this is probably related to ureteric smooth muscle spasm and trigonal irritation. Alpha-adrenoceptor antagonists reduce smooth muscle activity and are already widely used in medical expulsive therapy to aid passage of ureteric calculi. This meta-analysis incorporating five randomized controlled trials provides evidence that alpha-adrenoceptor antagonists reduce stent-related pain and storage symptoms as assessed by the Ureteric Stent Symptoms Questionnaire (USSQ). OBJECTIVES: • To evaluate the efficacy of α-blockers with respect to improving stent-related symptoms. • Ureteric stents remain a source of marked discomfort and their placement is often required after certain ureteroscopic procedures or in the acute setting. This analysis identifies and reviews the several studies that have investigated the role of α-blockers after stent placement. MATERIALS AND METHODS: • Pubmed/Medline, EMBASE, CINAHL and Cochrane Library databases were scrutinized using standard MeSH headings. • Randomized or controlled trials comparing α-blockers with control or standard therapy were included. • In all studies, patients completed the Ureteral Stent Symptom Questionnaire (USSQ). • The study data were independently reviewed by two assessors. RESULTS: • In total, five studies of varying quality were identified, including 461 patients receiving either tamsulosin or alfuzosin, or control. • On meta-analysis, all five studies showed a reduction in USSQ urinary symptom score and body pain scores. There was mean reduction of 8.4 (95% CI, 5.6-11.1) in the urinary symptom score and 7.2 (95% CI, 2.5-11.8) in the body pain score. • In three studies, the numbers of patients experiencing stent related pain were stated: 45% (51/114) of patients receiving an α-blocker experienced painful episodes within the follow-up period defined for that study compared to 76% (88/116) in the control groups, which is equivalent to a relative risk of pain of 0.59 (95% confidence interval, 0.47-0.71). • There were also reductions in other aspects of the USSQ, such as the general health score and sexual matters score, although these were not statistically significant or uniformly reported. CONCLUSION: • There is evidence that α-blockers provide an improvement in discomfort after placement of a ureteric stent.

Explaining the rise in antidepressant prescribing: a descriptive study using the general practice research database.

OBJECTIVE: To explore the reasons behind the recent increase in antidepressant prescribing in the United Kingdom. Design Detailed retrospective analysis of data on general practitioner consultations and antidepressant prescribing. Data source Data were obtained from the general practice research database, which contains linked anonymised records of over 3 million patients registered in the UK. Data were extracted for all new incident cases of depression between 1993 and 2005. Review methods Detailed analysis of general practitioner consultations and antidepressant prescribing was restricted to 170 practices that were contributing data for the full duration of the study. RESULTS: In total, 189 851 people within the general practice research database experienced their first episode of depression between 1993 and 2005, of whom 150,825 (79.4%) received a prescription for antidepressants in the first year of diagnosis. This proportion remained stable across all the years examined. The incidence of new cases of depression rose in young women but fell slightly in other groups such that overall incidence increased then declined slightly (men: 7.83 cases per 1000 patient years in 1993 to 5.97 in 2005, women: 15.83 cases per 1000 patient years in 1993 to 10.06 in 2005). Antidepressant prescribing nearly doubled during the study period-the average number of prescriptions issued per patient increased from 2.8 in 1993 to 5.6 in 2004. The majority of antidepressant prescriptions were given as long term treatment or as intermittent treatment to patients with multiple episodes of depression. CONCLUSIONS: The rise in antidepressant prescribing is mainly explained by small changes in the proportion of patients receiving long term treatment. Previous clinical guidelines have focused on antidepressant initiation and appropriate targeting of antidepressants. To address the costly rise in antidepressant prescribing, future research and guidance needs to concentrate on appropriate long term prescribing for depression and regular review of medication.

Is birth weight associated with risk of depressive symptoms in young women? Evidence from the Southampton Women's Survey.

Although some studies have shown negative associations between birth weight and risk of depression, others have not. Studies also differ regarding the age and gender specificity of reported associations. In this paper, the authors report on a study of 5,830 women aged 20-34 years from the general population in Southampton, United Kingdom, interviewed in 2000-2002 that found no relation between birth weight and current depressive symptoms or past treatment for depression. Prevalence ratios for current symptoms and for past treatment, in relation to reported or recorded birth weights, were all remarkably close to 1.0, with narrow 95% confidence intervals. For example, the prevalence ratio from the fully adjusted model for current depressive symptoms in relation to a standard deviation increase in reported birth weight was 1.01 (95% confidence interval: 0.98, 1.05). Generally, the associations reported elsewhere are not strong. The authors found a weak, inverse association in exploratory analyses of duration of gestation at birth in relation to depressive symptoms, but this finding requires replication. Because birth weight and duration of gestation are relatively poor markers of fetal development, other markers of fetal and early development should be explored. However, data from this study do not support a major developmental contribution to the etiology of depression in women.

Does perceived financial strain predict depression among young women? Longitudinal findings from the Southampton Women's Survey.

Background Social and financial environment has an influence on the incidence of depression. We studied perceived financial strain as a risk factor for development of depression among a large cohort of young women in Southampton, UK.Methods We recruited a large number of young women in Southampton in the Southampton Women's Survey, a longitudinal study looking at factors influencing the health of women and their offspring. Women were asked to complete a baseline questionnaire, which included the GHQ-12 (an assessment of mental health), as well as questions on perceived financial strain and past history of depression. They were followed up two years later through their general practitioner (GP) records for evidence of incident mental illness.Results A total of 7020 women completed the baseline questionnaire including the GHQ-12. Of these, 5237 (74.6%) had records available for follow-up. Among those developing depression, there was a higher proportion receiving benefits, and a higher level of perceived financial strain. There were also modest elevations in perceived stress, and poorer levels of educational attainment. Among women not depressed at baseline, and with no previous history of depression, those in receipt of state benefits at baseline had a significantly elevated risk of developing the disorder - hazard ratio 1.61 (95% confidence interval (CI) 1.13-2.3). The risk associated with perceived financial strain was 2.16 (95% CI 1.14-4.11), but this did not remain statistically significant after adjustment was made for receipt of benefits, educational qualification, and perceived stress.Conclusion Financial hardship as evidenced by receipt of benefits is a strong independent predictor for the development of depression. Although perception of financial strain is also a predictor for incident depression, the risk associated with this subjective characteristic does not remain significantly elevated after adjustment. Future studies of the aetiology of depression should incorporate ascertainment of actual financial status.

Use of antibiotics for sore throat and incidence of quinsy.

BACKGROUND: Quinsy is the most common major suppurative complication of sore throat. Evidence on the effectiveness of antibiotics in preventing quinsy is sparse. AIM: To assess the incidence of quinsy and the pattern of presentation, and to identify variables that predict the development of quinsy. DESIGN OF STUDY: Case-control study. SETTING: UK-wide primary care. METHOD: Retrospective analysis of data from the General Practice Research Database (GPRD) for the years 1995-1997. RESULTS: There were 606 recorded cases of patients with quinsy, but only 192 (31%) of these patients presented following an initially uncomplicated sore throat. Patients with quinsy were more likely to be aged 21-40 years (odds ratio [OR] = 2.5, 95% confidence interval [CI] = 1.7 to 3.6, compared with other ages), smokers (OR = 2.5, 95% CI = 1.8 to 3.5), and male (OR = 1.6, 95% CI = 1.1 to 2.2). Quinsy developed very quickly for most patients (median of 2 days after tonsillitis and 3 days after a sore throat). For cases initially labelled as tonsillitis, there was a nonsignificant trend of antibiotics preventing quinsy (OR = 0.6, 95% CI = 0.3 to 1.3), but no evidence that antibiotics prevent quinsy for cases labelled as sore throat or pharyngitis (OR = 1.2, 95% CI = 0.7 to 2.2). CONCLUSION: Most patients with quinsy develop the condition rapidly, and many do not present with a respiratory tract infection to their GP first. The current low doses of antibiotics used in modern community settings may be less likely to protect against quinsy than the trial evidence suggests.

Does lithium therapy protect against the onset of dementia?

Lithium compounds might theoretically play a role in preventing dementia by inhibiting formation both of beta amyloid and hyper phosphorylated tau protein. We carried out a case-control study to assess any possible clinical effects of lithium therapy on the diagnosis of dementia, using data from the General Practice Research Database, which collects routine data from primary care patients in the UK. Patients who received lithium had a higher risk of a diagnosis of dementia compared with those who did not (adjusted odds ratio 1.8, 95% CI 1.1-2.8). There was a trend toward increasing risk with increasing numbers of lithium prescriptions. This evidence does not support the use of lithium for preventing dementia.

Short course in pharmacoepidemiology and pharmacovigilance at the London School of Hygiene and Tropical Medicine.

Demand for education in pharmacoepidemiology is widespread, and has resulted in the short course at the London School of Hygiene and Tropical Medicine. This course is designed as an introduction but requires some scientific background to understand it. The course occurs annually, and covers basics of epidemiology, statistics and drug surveillance systems as applied particularly to drug safety issues. A successful completion results in a certificate from the University of London, and the course is accredited for continuing pharmacy and medical education purposes.